| NPI | 1548564297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWANA D. FEIMSTER President 571-312-3762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401412857) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |